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General NPI Number Information
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NPI Number | 1528154028
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Entity Type | Individual
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Provider Name | GERALD MATTHEW SIMMONS P.T.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 7615 INDIAN SCHOOL RD N.E.
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City | ALBUQUERQUE
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State | NM
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Zip | 87110
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Country | US
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Telephone | 505-888-7979
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Fax | 505-888-8859
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Provider Business Mailing Address
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Address Line | P.O. BOX 641
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City | TIJERAS
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State | NM
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Zip | 87059
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Country | US
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Telephone | 505-281-3262
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 421
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 421
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 421
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License Number State | NM
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